Overview
Spasmodic retrocollis, a form of laryngeal dystonia, involves involuntary contractions of neck muscles causing the head to tilt backward. It significantly impacts voice quality and can be debilitating 1.Diagnosis
Clinical Presentation: Involuntary backward tilting of the head 1.
Neurological Evaluation: Essential to rule out other neurological conditions 1.
Laryngoscopy: Utilizes rigid and flexible endoscopes to visualize laryngeal structures 2.
Airflow Analysis: Measures laryngeal resistance, subglottal pressure, and mean flow rate to differentiate subtypes (adductor vs abductor) 3.Management
First-Line Treatment: Botulinum toxin injections are the primary treatment 1.
Voice Therapy: Often combined with botulinum toxin injections to enhance outcomes 2.
Monitoring and Reassessment: Regular follow-ups to adjust dosing and evaluate efficacy 2.Special Populations
Comorbidities: No specific guidance provided in abstracts; individualized management based on overall health status is recommended 14.Key Recommendations
Use Botulinum Toxin Injections as the primary treatment for spasmodic retrocollis (Evidence: Strong 1).
Combine Botulinum Toxin Injections with Voice Therapy to improve voice-related quality of life (Evidence: Moderate 2).
Utilize Laryngoscopy and Airflow Analysis for accurate diagnosis and differentiation of spasmodic dysphonia subtypes (Evidence: Moderate 23).References
1 Benninger MS, Smith LJ. Noncosmetic uses of botulinum toxin in otolaryngology. Cleveland Clinic journal of medicine 2015. link
2 Gama AC, Menezes LN, Maia AA, Rezende Neto AL, Oliveira JB. Voice related quality of life after botulinum toxin injection for spasmodic dysphonia. Revue de laryngologie - otologie - rhinologie 2010. link
3 Hoffman MR, Jiang JJ, Rieves AL, McElveen KA, Ford CN. Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption. The Laryngoscope 2009. link
4 Kishore A, Lang AE. Normalization of voice in spasmodic dysphonia during transient global amnesia. Movement disorders : official journal of the Movement Disorder Society 2005. link